I Feel Therefore I Am

"The best and most beautiful things in the world cannot be seen or even touched. They must be felt with the heart" - Helen Keller

Ten years ago I wrote an article for Acupuncture Today titled, "We Are What We Think." 4

Now it seems that thought is out and emotion is in. Emotional intelligence is currently a household buzzword. Regardless of what is now trending, what is being discovered is that the link between thought, feeling and action is very fine. Really, it is more like the palm and the back of the hand, inseparable and distinct at the same time. Thankfully the attention to the mind/body connection in the medical science world is becoming more accepted. Unfortunately, the term, "mind/body connection," implies a separation between two objects. For the purposes of this article, please assume that the mind and body are one integrated entity that is actually not separate from anything else in this universe. All the great traditions of this world point toward unity, non-duality, and oneness. In indigenous medical paradigms, the emotions are an integral aspect of our experience and it is a foundational precept that disease and health are interdependent with the emotion/feeling/thought/action continuum.

Antonio Damasio, MD, the renowned neurologist, describes emotion as the physiological response to some outer or inner stimulus in his book, "Looking for Spinoza - Joy, Sorrow and the Feeling Brain." Feeling is our perception of the emotional physiological state. Thoughts come out of the milieu of the feelings, and vice versa, and produce more stimulus for emotion. What I would like to focus on is how we can consciously engage in this process and change the course of the habitual patterning of stimulus response that Damasio describes.

With the capabilities of functional MRI and PET scans, the physiological process of emotion and feeling are becoming visible. The process, as described by Damasio is like this: A stimulus, called an emotionally competent stimulus, occurs in the environment. The stimulus can be real or imagined. Multiple processing systems in the brain must be stimulated, such as visual and auditory. Olfactory and kinesthetic centers are important as well. This is the presentation stage. Once this reaches a critical mass of stimulus, other areas of the brain, that are emotion triggering are alerted. These triggering centers then activate emotion-execution sites. These sites release the hormones and neurotransmitters that create the feeling or emotional state that occurs throughout the body and the mind. This process can "reverberate and amplify itself, or shrivel away and close down."

Damasio relates how this process is much the same as the immune response encountering an antigen. The body encounters an invader, such as a bacteria or virus, the immune system detects it, sends signals, and a cascade of reactions become the immune response. In the case of the emotions, the amygdala in the temporal lobe, and the ventromedial prefrontal cortex in the prefrontal lobe, have been identified as the main emotional triggering sites. There are other sites that are not as well understood. The most prominent emotional execution sites that have been identified are the hypothalamus, and the pituitary gland. There are other sites, such as the insula that are also important but not fully elucidated. On the biochemical side oxytocin, vasopressin, dopamine, enkephalins, endorphins, and other neuropeptides and hormones are often found mediating our "state of mind."

In neurology much can be learned from specific traumas, or lesions, to particular areas of the brain. Those who have experienced lesions to specific regions having to do with emotion, will exhibit very specific deficiencies that can have profound effects on one's life, particularly in the social realm. Decision making becomes impaired when emotional centers are damaged. These people may be able to perform skills and intellectual tasks as they had before their injuries, their IQs remain intact, but their ability to relate to others and make decisions is deeply impacted by their inability to feel certain emotions, particularly sympathy, embarrassment or guilt. The implicated area in these cases is the ventromedial area of the right prefrontal lobe.

Regarding decision making, patients with these specific lesions who were making terrible decisions in their personal lives, would be able to perform well in the lab when given hypothetical scenarios that were similar to the situations they did so poorly with in their real lives. Damasio came to the conclusion that decision making was not so much a cognitive process, but an emotional one. Perhaps the cues we get from our feelings when faced with a decision helps guide us. This doesn't mean reasoning can't help us, but it does mean that in the end our feelings will dictate our actions. It is amusing to note that science is finally catching up to what advertising executives have known for quite a long time; that our actions are driven by emotion.

At UCSF, Dr. Wolf Mehling has been studying the connection between body/mind and chronic conditions. He has also been able to devise a way to quantify the degrees to which we are aware of our body/mind. "Body awareness, as we define it here, is the subjective, phenomenological aspect of proprioception and interoception that enters conscious awareness, and is modifiable by mental processes including attention, interpretation, appraisal, beliefs, memories, conditioning, attitudes and affect," said Mehling.

It is interesting to note that Mehling reports that body awareness in the medical literature is usually connected to an idea that more awareness leads to negative outcomes like anxiety, fixation on the pain, magnification of symptoms and a belief by the patient that the outcome will be for the worse. Mehling reports that when "body awareness is defined as the ability to recognize subtle body cues" the evidence suggests that contrary to traditional Western medical concepts about body awareness, greater awareness may be useful in treating many chronic debilitating disorders including low back pain, congestive heart failure, kidney failure and irritable bowel syndrome.

Dr. Mehling published an intriguing study that linked lack of awareness of inner emotions with greater incidence of back pain in bus drivers. In this study San Francisco Muni bus drivers were first put through a comprehensive questionnaire that quantified their level of awareness of their emotional/feeling state. A significant lack of awareness is called alexithymia. The drivers health history was examined for lower back pain. The results showed that those who were in the upper quartile of alexithymia were two times more likely to have had episodes of lower back pain. Clearly, our ability to be aware of our feeling states is linked to our health outcomes.

In body/mind practices, such as Yoga, Qi Gong, Chinese Medicine, Ayurveda, Feldenkrais, Reiki, body oriented psychology to name just a few, and all the indigenous medicine traditions practiced around the world, the connection between the emotional/thought realm and the physical body is real, it is fluid and it is foundational. Spirit is also an integral aspect of our being, and it is beyond the scope of this article.

The only reason that the emotional/feeling realm is popping up in the scientific community now is because the technology is finally able to begin to detect its presence. For all those "evidence based" practitioners out there I would like to suggest that it is not necessary nor prudent to have the entire physiological and anatomical underpinnings mapped out before we can benefit from this knowledge. I would also like to add that the more we integrate the power of our consciousness around our emotional/feeling life, as practitioners, and especially as stewards of our own individual health, into our modalities, the more suffering we will be able to alleviate.

I will end with a quote from the Dalai Lama:

"The great benefit of science is that it can make a tremendous contribution to the alleviation of suffering on a physical level, but it is only by cultivating the qualities of the human heart and transforming our attitudes that we can begin to address and overcome our mental suffering. We need both, since the alleviation of suffering must take place on both a physical and a psychological level."

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